DATE: Friday, November 28, 1997             TAG: 9711280099

SECTION: FRONT                   PAGE: A4   EDITION: FINAL 

TYPE: Focus

SOURCE: BY PHYLLIS SPEIDELL, STAFF WRITER 

                                            LENGTH:   60 lines

VARIETY BEST CURE, LOCAL DOCTORS SAY

Neurologist Robert C. Hansen believes industries could save millions of future dollars by spending a little money now to address such disorders as carpal tunnel syndrome.

According to the Portsmouth doctor, cumulative trauma disorders - carpal tunnel syndrome being the most common - are the leading causes of workplace injuries in the U.S.

Hansen was one of the first physicians in Perdue Farms Inc.'s pioneering on-site employee wellness centers program. The centers are seen as a possible way of reducing long-term medical compensation costs at poultry processing plants.

Carpal tunnel sydrome cases have increased 300 percent since 1986, and surgery often is part of the treatment.

Disagreeing with many orthopedists and hand surgeons who see surgery as the best treatment, Hansen urges a program that includes job and work site modification as well as medical management.

``Most carpal tunnel syndrome (cases) can be managed quite successfully without surgery,'' Hansen said. Besides, he said, patients who return to the same job with no task modifications run a significant risk of recurring symptoms.

Surgery also is a costly option for industry in terms of worker's compensation and lost time. Harry E. Payne Jr., North Carolina commissioner of labor, calls carpal tunnel syndrome an occupational health epidemic and estimates that compensation claims for that alone exceed $50 million.

``The costs to society are far greater because so many of these workers are never able to return to work,'' Payne said.

From 1992 to 1996, Hansen and Dr. Roger C. Merrill, Perdue's corporate medical director, tracked the treatment and progress of employees complaining of pain in their upper extremities to determine the impact of nonsurgical medical therapies.

The two recently submitted an article based on their findings to the Journal of the American Medical Association.

Of the 426 patients in their study, most historically would have been treated surgically. In these cases, however, treatments included job modifications to relieve repetitive motion stress, oral and injected medications, vitamins, splinting, ultrasound, applications of heat and cold, and specifically designed exercise regimens.

The study's findings indicated that carpal tunnel syndrome in an industrial setting responds overwhelmingly to nonsurgical treatments.

Dr. Bruce Tetalman, a partner in Hansen's practice and a specialist in physical medicine and rehabilitation, said the study findings are applicable to other industries as well. He has shared his opinion with consultants to local pork processors.

Tetalman said, ``We know that repetitive motion disorders can be prevented with early detection and management.''

And ``by applying a multifaceted nonsurgical approach to this disorder, patients are made more functional, and the costs to society - both in direct medical costs as well as indirect costs (due to unemployed workers, lost productivity, etc.) - are dramatically lowered.'' KEYWORDS: CARPAL TUNNEL SYNDROME REPETITIVE STRAIN INJURIES

RSI

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